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[Preliminary and Final Postmortem Examination and Death Certificate in the Emergency Medical Services in Germany:
André Nohl1,2,3,4, Benjamin Ondruschka5, Christian Afflerbach2,6
1Zentrum für Notfallmedizin, BG Klinikum Duisburg, Duisburg, Germany.
Background:
Inconsistent regulations and laws can lead to misunderstandings and incorrect procedures. In this study we would like to evaluate the heterogeneity of the different processes of postmortem examination and death certification in the German emergency medical services.
Methods:
An e-mail with a survey link was sent to 212 medical directors of emergency services. The questions were answered online.
Results:
The response rate was 47%. Regulated procedures were evident in 58% of the cases. Issue of provisional death certificate comprised 64%, postmortem examination 45%; 19.4% of emergency physicians were required to do the final post-mortem. In 41% of the cases, the application protocol was considered sufficient as a form of documentation. 45% of the participants evaluated the respective legal regulation as sufficient. Questions and concerns arose, especially when medical directors of EMS believed that the state-specific regulations were not sufficient (p<0.001).
Conclusion:
The results show that the obligatory post-mortem examination in Germany is heterogeneous in its processing procedures. More than half of the participants rate the existing legal regulations as inadequate. As a result, it is not uncommon for queries and complaints to arise, but above all for uncertainties to arise in everyday practice. Our results suggest that uniform legislation and clearly defined processes are desirable.
